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Merchant Account Pre-Application

Please fill out the application below. We will contact you by the next business day regarding your merchant account status. This is a free merchant account application and there is no cost or obligation . Now receive $100 off the licenced application of Summit Cart Shopping Cart software or 3 months FREE if you order the hosted applicationupon approval our your merchant account.

Please Note: The information you supply will be used only for the purpose of qualifying you for a merchant account by Summit Merchant. This information you provide is held in strict confidence and is never sold, rented, or shared with any other business or third party. Desert Dog Marketing, is an agent of Paradigm Services an ISO/MSP of JP Morgan Chase Bank, Hicksille NY.

Business Information
Business Name:
Business Address:
City, State, Zip Code:
Business Phone:
Business Fax:
Web Site Address:
Type of Business:
Business Start Date:
Does the owner have a Social Security Number?
Do you currently have a merchant account to process Credit Cards?
If yes who is your merchant account with:
Anticipated cost per item or service:
Anticipated monthly card sales volume:
Order Sources (must equal 100%)
In person sales (card is present & swiped): %
In person sales (card is imprinted only): %
Internet/Mail/Phone (card is not present or imprinted): %
Owner's credit:
 
Contact Information
Contact Name:
Email Address:
Best numbers to reach you at:
 
Notes or Comments You May Have?